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Öğe The Activity of Valproic Acid in the Treatment of Refractory Hyperleukocytosis in a Child with Acute Lymphoblastic Leukemia(TAYLOR & FRANCIS INC, 2013) Kose, Dogan; Koksal, YavuzHyperleukocytosis may be associated with an early morbidity and mortality due to leukostasis. Cytoreductive therapies-such as steroids, hydroxiurea, exchange transfusion, and leukapheresis-have been used for the prevention of leukostasis. Herein, the valproic acid used for the treatment of the hyperleukocytosis did not respond to known therapies in a child; lymphoblastic lymphoma developed bone marrow relapse under the treatment is discussed.Öğe Acute pancreatitis due to pancreatic involvement of Burkitt's lymphoma in a child(AVES, 2015) Erol, Cengiz; Kose, Dogan; Yuksekkaya, Hasan Ali; Koksal, Yavuz[Abstract not Available]Öğe The Correlation between the Level of Doxorubicin-Induced Cardiac Damage and Serum Soluble Fas in an Experimental Rat Model(WOLTERS KLUWER MEDKNOW PUBLICATIONS, 2018) Kose, Dogan; Ozdemir, Hulya; Celik, Zeliha Esin; Unlu, Ali; Artac, Hasibe; Koksal, YavuzAim: This study was planned to research the relationship between doxorubicin cardiomyopathy and the soluble Fas (sFas) level. Materials and Methods: Two groups of rats were included in the study. The control group was given physiological saline, while the study group was given doxorubicin. The rats, whose blood samples were taken weekly, were sacrificed and their myocardial tissues were removed. The tissues were examined in terms of morphological changes and surface Fas expression, while the blood samples were examined in terms of sFas level. Results: In the study group, the sFas levels at 2nd-9th weeks were higher than those found at 1st week before administrating the drug, and the increase at 2nd-7th weeks was meaningful. In addition, sFas levels were gradually increased each week during 1st-5th weeks when compared to the values of a previous week, and the increase during the first 4 weeks was meaningful. After the 5th week, the values gradually decreased each week. The mean values of the study group at 1st-8th weeks were higher than those of the control group, and the increases at 2nd-8th weeks were meaningful. The severe forms of interfibrillar hemorrhage, vascular dilatation, myocardial necrosis, inflammatory infiltration, and splitting of muscle fibers occurred with 15, 15, 17.5, 20, and 22.5 mg/kg dose of medicine, respectively. Conclusions: As the tissue injury increased, the increasing cell-surface Fas expression and sFas plasma level at the acute phase of doxorubicin-related cardiotoxicity decreased. The sFas level determined at acute phase may be helpful in predicting the existing injuries and possible late-term problems.Öğe Desmoplastic non-infantile astrocytic tumor with BRAF V600E mutation(SPRINGER JAPAN KK, 2014) Karabagli, Pinar; Karabagli, Hakan; Kose, Dogan; Kocak, Nadir; Etus, Volkan; Koksal, Yavuz[Abstract not Available]Öğe Development of fatty liver in children with non-Hodgkin lymphoma(TURKISH J PEDIATRICS, 2014) Kose, Dogan; Erol, Cengiz; Kaya, Fatma; Koplay, Mustafa; Koksal, YavuzThe aim of this study is to investigate the development of hepatosteatosis in children with non-Hodgkin lymphoma. Twenty-eight patients were evaluated retrospectively for hepatosteatosis by computed tomography. Mild, moderate and severe hepatosteatosis were defined as the difference between the average liver attenuation and the average spleen attenuation, equaling (- 10) - (- 19); (- 20) - (- 29); and >= 30 HU, respectively. "Vaguely" and "obvious" hepatosteatosis were defined as none or mild hepatosteatosis, and moderate and severe hepatosteatosis, respectively. In T-cell lymphoma, obvious hepatosteatosis was determined in 1 of 12 patients (8.3%) at the first evaluation, 8 of 12 patients (66.7%) at the second evaluation and 4 of 12 patients (33.3%) at the third evaluation. In B-cell lymphoma, obvious hepatosteatosis was determined in none of 16 patients at the first evaluation, 2 of 16 patients (12%) at the second evaluation and none of the patients at the third evaluation. In the second evaluation, severe high serum total cholesterol and triglyceride levels were determined in 4 of 5 patients. We observed higher fatty liver ratios, and high triglyceride and cholesterol levels, although the data were obtained from a small number of patients.Öğe Diagnostic Value of Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography in a Patient with Adrenal Involvement of Hodgkin Lymphoma(GALENOS YAYINCILIK, 2016) Kose, Dogan; Koksal, YavuzImproved success with the modern management of Hodgkin lymphoma (HL) leaded new method searches to diminish treatment intensities in order to prevent late effects. Sensitivity and specificity of fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-CT) is advanced in the determination of malign cell infiltrations in adrenal glands in patients with HL which is a rare finding. A 7.5 year old female patient that was investigated due to pubic hairs and breast development one year ago presented, with complaints of recently developed fever, asthenia, weight loss and night sweating. In her examination, hepatosplenomegaly, phase 2 pubarche and phase 1 thelarche were detected; in FDG PET-CT, advanced lymph node involvement and increased activity in spleen and left adrenal gland were also detected. The patient was diagnosed with HL by biopsy and premature pubarche (PP) by the laboratory values. In the patient, FDG PET-CT that is recorded after the antineoplastic treatment was completely normalized; pubarche and thelarche were completely rested and, normal puberty started when she was 12 years old. The patient has been followed up currently without any problems. In this report, a pediatric HL case with PP and increased activity in left adrenal gland determined by FDG PET-CT, has been presented.Öğe Effects of Prednisolone, l-Asparaginase, Gemfibrozil, and Combinations of These Elements on Mice Lipid Profile, Liver, and Pancreas(LIPPINCOTT WILLIAMS & WILKINS, 2016) Kose, Dogan; Tarakci, Nuriye; Celik, Zeliha Esin; Vatansev, Husamettin; Cimbek, Emine Ayca; Ugras, Serdar; Sen, YasarThe aim of this study is to determine the effects of l-asparaginase (l-ASP), corticosteroids (CSs), and antilipidemics, separately and in combination, on the lipid profiles and the liver and pancreas histology in mice. This study included 8 groups of 7 mice each. Before any drug administration, serum samples were taken from all of the mice. Then, normal saline was applied to the control group, and a medication or combination of medications was applied to the other groups. Levels of triglycerides, cholesterol (COL), and high-density lipoprotein (HDL) and low-density lipoprotein (LDL) were determined, and the livers and pancreases were evaluated histologically at the end of the study. Triglycerides increased significantly in the CS-only and the l-ASP-only groups, COL increased significantly in the CS-only group, and HDL increased significantly in the CS-only and the antilipidemic-only groups. LDL was significantly lower in the CS-only and the l-ASP-only groups. CSs and l-ASP were significantly effective in liver necrosis, l-ASP was significantly effective in liver balloon degeneration, and CS were significantly effective in pancreas vacuolization. Triglyceride measurement is recommended before/during CS and/or l-ASP treatment. Starting with an antilipidemic agent can be considered to avoid possible complications in patients with significantly high rates. Indicators of a possible liver or pancreas injury should also be considered.Öğe Elevated alpha-fetoprotein in benign/borderline liver masses in children(KARE PUBL, 2015) Kose, Dogan; Erol, Cengiz; Koksal, YavuzOBJECTIVES The purpose of this retrospective study is to share the data of the patients with high alpha-fetoprotein and benign/borderline liver mass with literature. METHODS Between 2006 and 2012, 5 of our patients were diagnosed with benign/borderline liver mass in connection with high alpha-fetoprotein. RESULTS During the diagnostic procedure, alpha-fetoprotein values of our patients were varying between 123-4905 U/L. While one of the patients diagnosed with hemangioendothelioma was transferred for liver transplantation, the other passed away during the early stages under steroid treatment. After observing malign cells in tissue biopsy, chemotherapy was started for the patient diagnosed with mesenchymal hamartoma and the mass was removed completely. It is currently being monitored and is free of any diseases. Patients, who were diagnosed with hemangioma and focal nodular hyperplasia, were monitored without receiving any treatment. CONCLUSION Since it is possible to observe high alpha-fetoprotein in non-malign liver masses, tissue diagnosis must be confirmed before starting treatment.Öğe Growth-differentiation factor-15 and tissue doppler imaging in detection of asymptomatic anthracycline cardiomyopathy in childhood cancer survivors(PERGAMON-ELSEVIER SCIENCE LTD, 2013) Arslan, Derya; Cihan, Tugba; Kose, Dogan; Vatansev, Husamettin; Cimen, Derya; Koksal, Yavuz; Oran, BulentObjectives: Anthracyclines have led to an increased risk of cardiac morbidity and mortality. Late cardiac complications in cancer survivors may develop from subclinical myocardial damage. Tissue Doppler imaging (TDI) also has potential as a clinically useful technique for the assessment of myocardial function. Biochemical markers may be used to detect cardiac damage growth-differentiation factor-15 (GDF-15) and are emerging as a biomarker of cardiac dysfunction. The aim of this study is to assess the value of the plasma levels of GDF-15 and TDI in detecting late myocardial dysfunction in childhood cancer survivors (CCS) who were treated with anthracyclines. Design and methods: Thirty-eight CCS who had completed chemotherapy treatment with anthracyclines were included in this study. Control group consisted of 32 age- and gender-matched healthy volunteers. All children underwent a detailed echocardiography, which contained an M-mode, pulse Doppler and tissue Doppler imaging. However, GDF-15 and cardiac troponin-I (cTnI) were measured. Results: Although, systolic function of the left ventricular was similar in all groups, there were significant differences between parameters of diastolic function of the heart. The mitral valve E wave, E/A ratio, left ventricular E'm wave, and E'm/A'm ratio were different in the patients than in the controls (p = 0.049, p = 0.037, p < 0.0001, p = 0.001, respectively). The tricuspid valve E/A ratio, right ventricular E't wave, and E't/A't ratio in the patients were also different from those of the controls (p = 0.031, p < 0.0001, p < 0.0001, respectively). Mean plasma GDF-15 was significantly higher in patients than healthy controls (p = 0.027). There were no significant differences in cTnI between both groups. Conclusions: Growth-differentiation factor-15 level may be used as a biomarker of anthracycline-induced cardiovascular disease severity in the CCS. (c) 2013 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.Öğe High-risk febrile neutropenia and its management in children with solid tumors and lymphoma(TUBITAK SCIENTIFIC & TECHNICAL RESEARCH COUNCIL TURKEY, 2015) Kose, Dogan; Emiroglu, Melike; Koksal, YavuzBackground/aim: The clinical characteristics and treatment results of febrile neutropenia attacks that occurred in patients with lymphoma and solid tumors were analyzed. Materials and methods: A total of 50 patients with 94 high-risk attacks were evaluated for malignant diseases in this study. Results: The fever etiology was determined as clinical (50%), microbiological (5.31%), clinical-microbiological (5.31%), or unknown (39.3%). A few of the attacks (21.3%) were observed in lymphoma cases and 77.7% were observed in patients with solid tumors. Patients who were in remission had 59.6% of the attacks, and 39.4% occurred in patients not in remission. Among the groups tested, 73% (the imipenem/amikacin group) and 47.9% (the piperacillin-tazobactam/amikacin group) of patients were in remission. Glycopeptide addition rates in these groups were 22.2% and 40.8% and antifungal addition rates were 8.8% and 18.3%, respectively. Conclusion: Clinical progress was more problematic in patients who were not in remission during the attacks. This was due to the fact that some patients had other factors that placed them in the high-risk group, as well as increased C reactive protein and procalcitonin values on the first day. Therefore, it may not be accurate to associate the success achieved in the different treatment regimens with antibiotics alone.Öğe Intracranial metastasis of neuroblastoma: in two different areas at the same time(SPRINGER, 2013) Kose, Dogan; Karabagli, Pinar; Yavas, Guler; Karabagli, Hakan; Koksal, YavuzNeuroblastoma (NB) is the most common extracranial solid malignancy in children. The major cause of death from this cancer is metastasis of tumors, and metastasis can be seen in different areas of the body. Metastasis of NB occurs by hematogenous and lymphatic routes. Generally, brain metastases have been reported in only one area of the brain parenchyma. A 4-year-old male patient was treated in our clinic due to the NB that settled in the intra-abdominal region, but the patient presented with headache and nausea approximately 5 months after completion of the treatment. Whereupon, cranial imaging was performed and two masses were detected in the bilateral frontal lobe, and then the patient underwent surgery. Metastatic NB diagnosis was confirmed histopathologically. The patient's chemotherapy treatment is still ongoing. We report the case of a male patient with two separate metastatic masses in the brain parenchyma, which occurred in two different areas at the same time.Öğe Isolated Scrotal Skin Relapse in a Child with Burkitt Lymphoma(GALENOS YAYINCILIK, 2015) Kose, Dogan; Kivrak, Ali Sami; Ugras, Serdar; Koksal, YavuzBurkitt lymphoma (BL) that is the most rapidly growing human tumor is an aggressive B-cell neoplasia. It generally occurs as an extranodal disease. Its metastasis into extranodal areas is also frequent, however, its cutaneous involvement is rare. An 11-year-old male presented with the complaints of abdominal pain and difficulty in swallowing. The patient was diagnosed with BL by trucut biopsy that was performed for a mass identified in the left upper abdominal quadrant and B-cell Non-Hodgkin's lymphoma (NHL) BFM 95 treatment protocol was applied. The patient applied again for the complaint of right scrotal swelling 1.5 months after the completion of therapy. On physical examination, right scrotal edema and redness were identified. The patient was diagnosed with relapsed BL by biopsy taken from scrotal skin and LMB-Group C treatment protocol was applied. The patient came again with the complaints of abdominal swelling and pain 20 months after the completion of therapy. On physical examination, a mass was detected in the left mid-upper quadrant of the abdomen. The result of biopsy was reported as BL again and COPM (cyclophosphamide, vincristine, prednisolone, and methotrexate) treatment protocol and rituximab were started. However, central nervous system (CNS) relapse developed and the patient was lost. This case was presented because isolated scrotal skin relapse has not been reported in the literature.Öğe Neurological complication of non Hodgkin lymphoma in childhood: experience from a single center in Turkey(SPRINGER, 2014) Kose, Dogan; Paksoy, Yahya; Koksal, Yavuz; Unal, EkremLymphomas are the third most common childhood malignant disease after leukemia and central nervous system (CNS) tumors. Early diagnosis of these complications will reduce mortality and morbidity. In this study we aimed to review the neurological complications of childhood non Hodgkin Lymphoma (NHL). Forty four children with NHL between 2006 and 2012 were investigated retrospectively and 14 cases with neurological complications were identified. The most common symptom was alteration of the consciousness (10 patients, 71.4 %) followed by convulsion (5 patients, 35.7 %), and hallucination (4 patients, 28.5 %); headache, eye pain, neurogenic bladder, speech disability and facial paralysis, and hemiplegia, were less common and each of them was seen in 1 (7.1 %) of the patients. The neurological complications were mostly seen in children with precursor T lymphoblastic lymphoma followed by anaplastic large cell lymphoma. The complications were secondary to medications (Eight patients) infection (two patients); CNS relapse (two patients); or CNS involvement of the primary disease (two patients). Chemotherapy-related neurologic complications were secondary to intrathecal methotrexate, l-asparaginase, vincristine, and ifosfamide Advanced disease and PTLL subtype can be suggested as predictors of neurological complication. The survival rates of neurological complications are fairly good unless it is secondary to involvement of the primary disease. In patients with drug-induced neurological complications, the treatment can be safely re-administered after controlling the neurological complications. Therefore, clinicians managing children with NHL must be informative about neurological complications.Öğe Neurothekeoma in childhood: a benign tumor mimicking malignant disease(TURKISH J PEDIATRICS, 2014) Kose, Dogan; Ugras, Serdar; Harmankaya, Ismail; Ciftci, Ilhan; Koksal, YavuzNeurothekeoma (NT) sometimes extends to subcutaneous adipose tissue, skeletal muscle or epidermis, and thus may imitate some malignant situations. A 17-year-old female patient was admitted to another medical center with a swelling at her waistline. Plexiform fibrous histiocytoma was diagnosed, and she was referred to our clinic. Total re-excision was performed. The new pathology report indicated features of atypical NT. A case of atypical NT, which can be misdiagnosed as a malignant mesenchymal tumor, is discussed in this paper.Öğe Pilomatrixoma in childhood(MEDKNOW PUBLICATIONS & MEDIA PVT LTD, 2014) Kose, Dogan; Ciftci, Ilhan; Harmankaya, Ismail; Ugras, Serdar; Caliskan, Umran; Koksal, YavuzContext: Pilomatrixoma is a benign tumor of the skin. Malignant transformation can be seen rarely in the small percentage. Aim: The aim of the following study is to attract attention to this tumor in the differential diagnosis because if it is not kept in mind it leads to both unnecessary interventions and treatments for the patient. Patients and Methods: From January 2006 to December 2012, 8 patients with pilomatrixoma were evaluated retrospectively. Results: A total of 8 pediatric pilomatrixoma patients charts were reviewed retrospectively. None of the patients had familial feature. Of 8 patients 4 (50%) were male and 4 (50%) were female. The patients age ranged from 2-18 years with a median age 11.5 years. All of the patients were admitted with the complaint of swelling at the lesion site. Two patients have multiple lesions, one of them has two and other has three lesions. A total of 11 lesion were detected in our 8 patients that 5 of them were located upper extremities (46%), 3 of them cervical region (27%), 2 of them on occipital region (18%) and 1 of them in the sacral region (9%). All lesions were excised completely. Until now, no patient had evidence of recurrence or malignant disease. Conclusion: As a result pilomatrixoma is a benign tumor, with atypical forms and unfortunately, no tumor-specific diagnostic feature except of a careful histopathological examination is available.Öğe Role of Tenascin-C in the differential diagnosis of small round blue cell tumors(2015) Kose, Dogan; Kaya, Fatma; Unlu, Ali; Koksal, YavuzGiriş: Bu çalışma; küçük yuvarlak mavi hücreli tümörlerde, serum tenascin-C düzeylerinin teşhis, tedavi ve takiplerdeki yerinin değerlendirilmesi amacıyla planlanmıştır. Gereç ve yöntem: Bu prospektif çalışmaya; 40 hasta ve kontrol grubu olarak 30 sağlıklı çocuk alındı. Hastalardan; tanı anında, tedavinin 3. ve 6. aylarında ve tedavi bittikten sonraki 3. ayda toplam dört defa, kontrol grubundan ise; bir defa serum örneği alınarak tenascin-C düzeyleri ölçüldü. Bulgular: Tüm hasta grubunun her dört ölçüm değeri de kontrol grubuna göre anlamlı derecede yüksekti (sırasıyla; p0,013, p0,009, p0,011 ve p0,015). Tüm hasta grubu alt gruplarına ayrılarak karşılaştırıldığında ise; sadece Wilms tümörü grubunun, ilk ölçüm değeri, kontrol grubuna göre anlamlı derecede yüksekti (p0,026). Sonuç: Daha geniş hasta gruplarının katılımıyla yapılacak çalışmalara ihtiyaç olmakla beraber tenascin-C, Wilms tümörü grubunda olduğu gibi, bazı spesifik tümörlerin ayırıcı tanısında yol gösterici olabilirÖğe Synovial sarcoma in a premature newborn(WILEY-BLACKWELL, 2014) Kose, Dogan; Annagur, Ali; Erol, Cengiz; Ugras, Serdar; Koksal, YavuzSynovial sarcoma is rarely detected in infants, with an annual incidence of 0.5 per million. Synovial sarcoma occurs more frequently in adolescents and young adults, with the majority of patients presenting between 15 and 40 years of age. It is extremely rare, however, in pediatric patients under 2 years of age. In the present study we examined a 3-day-old male infant born at 32 weeks who had a mass on his left arm. Synovial sarcoma was identified on histopathological and immunohistochemical analysis of biopsy material acquired from the mass. On whole body magnetic resonance imaging, diffuse metastases were detected in the bilateral lungs in the retroperitoneal zone, in bilateral suprarenal glands, the right liver lobe, the right kidney, and the brain. To our knowledge this is the youngest patient to be diagnosed with synovial sarcoma in the literature.
